Will blood flow restart if I have had vascular occlusion near the upper lip corner after Juvederm? (photo)

Thank you for sharing your question and photograph.  Based on your picture alone this is not the typical appearance of a vascular occlusion and I would favor continued treatment with hyaluronidase to dissolve residual Juvederm.  Hope this helps.

Continue to use hyaluronidase to reverse the filler.  Occlusion symptoms are more than what you are describing.  Best, Dr. Eemr.

This sounds like a complicated situation and I'm sorry this happened to you. Your symptoms are not all consistent with vascular occlusion and you should consider having more enzyme injection in an effort to get rid of the lump. Best wishes, Dr. ALDO

Thank you for your question. Based on your photo this does not look like typical vascular occlusion. Vascular occlusion is a blockage of a blood vessel, typically with a clot. I would continue your treatment with hyaluronidase to dissolve the Juvederm. Best of Luck!

Thanks for the question and the photo – it is helpful. We always recommend that you have these injections in the offices of board certified dermatologists or plastic surgeons as we are the true experts in how to use fillers, and more importantly, what can be done if something goes wrong.  The photo shows a lump and it appears not to be related to any vascular occlusion – just too much filler in the area. We would, as others have noted, put more and more hyaluronidase in the area and let the material dissolve. Your provider had to consult an expert – maybe you need an expert injector next time.

It is extremely difficult to assess the area from the photo. It does not appear to be an occlusion and it can likely be resolved with Hyaluronidase injections. 

As with any patient posting on here I would recommend an in person evaluation of the area and to even obtain a second opinion if necessary.  It looks more like a conglomeration of filler in that area, rather than a vascular occlusion.  I would continue trying to dissolve the product to see if you can get it to resolve.  If it were vascular occlusion you would want the filler dissolved as well in order to recover blood flow to the area asap in order to maintain tissues being alive.  Good luck with your recovery.

This is not vascular occlusion. More hyaluronidase needs to be done. Make sure you use a brand named hyaluronidase because compounded hyaluronidase can be weaker. Also consider 5FU if you don't see improvements.

Thank you for your photo with your question. A vascular occlusion is typically associated with extreme pain and tissue ulceration. The pain is typically immediate and or within a couple hours of treatment. Because you are not describing these symptoms, I doubt that vascular occlusion is what caused the pale lump 4 days after the injections. More likely, is that for some reason the juvederm moved and accumulated in that location and as it absorbed water over those first few days, became more noticeable.  My recommendation is that the lump can be dissolved, by an expert, with hyaluronidase.  In regards to your question about blood flow being restored: When vascular occlusion is treated right away, blood flow can be restored- this is always the hope. Thankfully, the blood supply to the face is very robust and blood flow is typically restored and the facial tissues recover. I hope this helps.Dr. Quenby Erickson

Thank you for sharing your photo and for your question.  Delayed vascular occlusion is caused by swelling as the hyaluronic acid (#Juvederm, #Volift, #Vobella, #Restylane) absorbs water over the first two weeks.  The swelling can put pressure on and compress the blood vessel(s).  The most common result is blanching (the white discoloration you are describing) or a dusky (bruised-like) appearance.  In some cases, the skin does not receive enough blood to stay healthy (necrosis). I recommend repeated flushing of the area with hyaluronidase and Lasix.  Your expert physician may use 1000 units or more to dissolve the Juvederm in this area.  It can be re-injected after 2-3 weeks.  The diuretic (Lasix) will decrease the edema  that is putting pressure on any blood supply to the corner of the mouth. Best of luck,Suneel Chilukuri, M.D.Houston, Texas